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基于强直性脊柱炎患者不同表现的肾脏受累危险因素

Risk Factors of Renal Involvement Based on Different Manifestations in Patients with Ankylosing Spondylitis.

作者信息

Wu Yan, Zhang Guangli, Wang Niansong, Xue Qin

出版信息

Kidney Blood Press Res. 2018;43(2):367-377. doi: 10.1159/000488071. Epub 2018 Mar 8.

Abstract

BACKGROUND/AIMS: Renal involvement is one of the most common extra-articular complications caused by ankylosing spondylitis (AS). Most studies have focused on the incidence rate, clinical manifestation and pathology, while risk factors have hardly been investigated. Therefore, the objective of this study was to assess the risk factors of renal involvement in patients with AS.

METHODS

Clinical and biochemical data of 926 AS patients were collected. Based on the manifestations of renal involvement, patients were divided into three groups and the differences in clinical and biochemical characteristics were compared. A group with non-renal involvement served as a control. Multivariable logistic regression was used for analyzing risk factors of renal involvement in AS.

RESULTS

Of the 926 AS patients, 201 patients suffered from renal involvement. Moreover, female AS patients faced a higher risk of hematuria compared to male patients. As indicated by the data obtained from multivariate logistic regression analysis, gender, uric acid (UA), immunoglobulin A (IgA), and serum albumin (ALB) were found to be risk factors of renal involvement in AS. An increase in UA or IgA levels, or a decrease in ALB level can increase the risk of renal involvement with multiple manifestations (more than one manifestation of renal damage). According to our findings, no definite variable was identified as a risk factor of proteinuria in AS patients.

CONCLUSION

In AS patients, UA, IgA, and ALB levels can indicate the risk of renal involvement in AS patient and need to be paid special attention. Furthermore, women are subjected to a higher risk of hematuria.

摘要

背景/目的:肾脏受累是强直性脊柱炎(AS)最常见的关节外并发症之一。大多数研究集中在发病率、临床表现和病理学方面,而危险因素几乎未被研究。因此,本研究的目的是评估AS患者肾脏受累的危险因素。

方法

收集926例AS患者的临床和生化数据。根据肾脏受累表现,将患者分为三组,比较临床和生化特征的差异。将未发生肾脏受累的一组作为对照。采用多变量逻辑回归分析AS患者肾脏受累的危险因素。

结果

926例AS患者中,201例发生肾脏受累。此外,女性AS患者血尿风险高于男性患者。多变量逻辑回归分析数据表明,性别、尿酸(UA)、免疫球蛋白A(IgA)和血清白蛋白(ALB)是AS患者肾脏受累的危险因素。UA或IgA水平升高,或ALB水平降低会增加出现多种表现(一种以上肾脏损害表现)的肾脏受累风险。根据我们的研究结果,未确定明确变量为AS患者蛋白尿的危险因素。

结论

在AS患者中,UA、IgA和ALB水平可提示AS患者肾脏受累风险,需要特别关注。此外,女性血尿风险更高。

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